Sullivan, Ulster rank high in rate of orders written

Sunday

Sep 30, 2012 at 2:00 AM

HEATHER YAKIN

From 2009 to 2011, a steady march upward in both the number and rate of prescriptions written for opioid painkillers and anti-anxiety medications was documented in our region.That pattern follows statewide and national trends, trends coupled with rising numbers of people seeking treatment for prescription drug addiction. The sales of prescription opioid pain relievers nationwide ballooned between 1999 and 2010. The Centers for Disease Control and Prevention sounded the alarm in late 2011, when an analysis showed that in 2010, drug overdose deaths outpaced motor vehicle deaths. More than half of the drug overdose fatalities involved prescription drugs, and nearly three-quarters of those fatalities were because of opioid painkillers.An analysis of prescription numbers for counties in New York obtained from the state Department of Health shows that more and more prescriptions are being written in our region for these potentially addictive medications.From 2009 to 2011, Sullivan County was among the top 10 counties for rate of opioid painkillers prescribed. Ulster County has been in the top 10 for benzodiazepines – a class of drugs including Xanax, Valium, Ativan and Librium used medically to ease anxiety or insomnia. Orange County places in the middle third among New York counties for prescription rates in both drug classes.

Methadone, itself a long-acting opioid, is used to treat opiate addiction. The controlled, regimented dosages used in treatment prevent withdrawal symptoms without providing a high. Not all people with opiate addiction will need methadone treatment, but it's appropriate in many cases, particularly for people who have persistent withdrawal symptoms even after detox. Some programs also offer buprenorphine, another opioid medication.

About a year ago, the methadone maintenance program run by the Greater Hudson Valley Family Health Center, which serves Orange and Sullivan counties, increased the number of treatment slots from 300 to 350, and Greater Hudson has applied to raise the number to 400. “There will still be significant demand,” said Greater Hudson spokesman Ken Mackintosh. “Even increasing us to 400 will not eliminate our waiting list.”That's a statewide trend, according to the state Office of Alcoholism and Substance Abuse Services. In a live webinar on Friday, Steve Hanson, associate commissioner of the OASAS Division of Treatment and Practice Innovation, said the agency has seen a 150 percent increase in recent years in the number of people ages 18 to 35 who are admitted to addiction treatment with a prescription drug as their primary drug of abuse.In Ulster County, Health Alliance of the Hudson Valley operates a methadone clinic, as well as in- and outpatient drug rehabilitation programs. The methadone clinic there expanded about a year ago from 150 to 200 slots, said Allen Nace, director of addictions treatment for Health Alliance, and the program is seeing significant numbers of people who are illicitly using prescription drugs.“At the end of the day, all of these people are just people,” Nace said. “I've treated people from amazing walks of life, in all socioeconomic categories. It's addiction, and it crosses all boundaries.”About 50 percent of the people seeking treatment in the Health Alliance detox program have a diagnosis related to opiates, Nace said; about 15 percent are a combination of opiates and benzodiazepines. Many people with benzodiazepine dependence aren't approved for these short-term detox programs, Nace said, because withdrawal from the anti-anxiety medications can take weeks.

New York recently passed I-STOP, the Internet System for Tracking Overprescribing, a real-time computer database that doctors and pharmacists will use to log all prescriptions for certain drugs. The law was approved with an eye toward capping the supply of diverted drugs by thwarting people who seek multiple prescriptions.

According to the CDC, 55 percent of people who abuse prescription painkillers get them from a friend or relative for free, 11.4 percent paid the friend or relative and 4.8 percent stole them from a friend or relative. Just over 17 percent got them with a doctor's prescription.The CDC also found that about 20 percent of licensed prescribers account for 80 percent of the prescriptions written.Mackintosh said Greater Hudson's doctors are very mindful of why they're prescribing medications and of whom they prescribe them to. Like other providers, they're alert to the phenomena of doctor-shopping and drug-seeking behaviors. Nace also said most doctors he's encountered are conscientious in their prescribing.In the Center for Disease Control and Prevention's June 8 edition of Morbidity and Mortality Weekly Report, an annual survey of high school students showed that 20.7 percent of students had, at some point, taken a prescription drug without a doctor's prescription.Overall, according to the CDC, more than 12 million Americans reported using prescription painkillers for nonmedical purposes in 2010.There were 1,718 overdose deaths in New York in 2009, 70 percent of which were because of opioids, including heroin and prescription drugs, according to OASAS.“Opiates are readily available illicitly,” Nace said. People often get them from friends or relatives, with or without their knowledge, he said, and how far they'll go for drugs depends on the individual's own ethics and whether the person has crossed from being dependent to being an addict.“If you have a physical dependence, you withdraw and you go on with your life,” Nace said. “Once the addiction kicks in, it becomes your life.”hyakin@th-record.com

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